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immunizations & vaccines

It seems like every year there are several outbreaks of meningococcal infections on college campuses across the country. This disease is caused by a bacterium called n. meningitides which can infect both the brain and the blood. Although meningococcal infections are rare even with treatment this infection can be deadly in 10-15% of patients. Those who survive can experience permanent disabilities like amputation, hearing loss, brain damage, kidney damage, and scarring from skin grafts. As a student at The Ohio State University you are required to be vaccinated for meningitis before you can live in university housing. This vaccine covers meningitis type A,C,Y, and W-135. It does not cover meningitis B which causes nearly half of meningitis cases in patients aged 17-22. There are currently two vaccines on the market for meningitis B, Trumenba and Bexsero. Both vaccines are approved in the United States for patients aged 10-25 for the prevention of meningococcal type B infection. Although the medication is approved for 10-25 the Advisory Committee on Immunization Practices and the CDC give these recommendations.

These vaccines are recommended for patients ten years and older who:

Are at risk due to a type b outbreak

Have a damaged or removed spleen

Have an immune system condition known as “persistent complement component deficiency.”

Are taking eculziumab (Soliris)

Routinely work with N. meningitides.

There is an additional recommendation that the vaccine may be given to anyone aged 16-23 with a preferred age of vaccination being 16-18. This allows patients and their healthcare providers to determine if they want the vaccine.

Both vaccines require multiple doses. Bexsero is a two dose series with the doses being administered at least one month apart. Trumenba can be a two or three dose series depending on your risk level for meningococcal B infection.

Are these your thoughts when asked if you will get the flu shot this year?

Everyone’s immune system works differently so some people get sick more often than others. Just because you “never” get sick does not mean you are invincible from getting the flu. Influenza is spread by respiratory droplets (from sneezing, coughing, or even just talking) which can directly or indirectly be spread from person to person. If an infected person sneezes and then touches a door handle, you are at risk of getting infected just from touching that same door handle. All it takes is one infected individual on campus to be able to spread it to many, many others.

Why should you get vaccinated against the flu?

Influenza is a potentially serious disease that can lead to hospitalization and sometimes death. Each flu season is different, and influenza can affect people differently, but millions of people get the flu every year. Of those millions, hundreds of thousands of people are hospitalized and thousands or tens of thousands of people die from flu-related causes every year. An annual influenza vaccine is the best way to help protect yourself and others against the flu. Vaccination has been shown to have many benefits including reducing the risk of flu illnesses, hospitalizations and even the risk of flu-related death in children.

How do flu vaccines work?

The flu vaccine contains dead strains of the influenza virus. When vaccinated, these injected dead viruses cause antibodies to develop in the body about two weeks after vaccination. These antibodies provide protection against infection with the viruses that are in the vaccine. Therefore, if you are exposed to the flu later in the season, your immune system will be ready to defend you from getting infected with the virus. A lot of people claim that they get sick right after receiving the vaccine. It is scientifically impossible to get the flu from the vaccine since dead viruses are injected and it takes two weeks for your body to develop antibodies. The reason some people may feel flu-like symptoms after getting the vaccine is because your body’s immune system is triggered when injected with the vaccine but that is a risk with any vaccine you receive.

Who should get vaccinated this season?

Every person over the age of 6 months old should get a flu vaccine every season. The reason you need to get a vaccine every year is because each year, the strains of viruses are a little bit different. Therefore, a new vaccine is created each year to protect you against the projected strains of influenza for that given year.

When should you get vaccinated?

You should receive your flu vaccine before the flu begins spreading in your community since it takes two weeks for your body to develop the antibodies necessary to protect you. The CDC recommends that people get a flu vaccine by the end of October each year.

Where can you go to get vaccinated?

You can get your flu shot conveniently right on campus at the student health center! Flu shots are available at the pharmacy located on the ground floor. In addition, you can get your flu shot at your doctor’s office, clinics, health department, or at any retail pharmacy.

Growing up sleeves were a big no-no. We weren’t supposed to use our sleeves to wipe our noses or our mouths. We weren’t supposed to stretch out our sleeves. And we weren’t to use our sleeves as rags to wipe things down. Sleeves were to be – well – sleeves.

The wiping of the nose thing – that’s still good advice, but our sleeves can serve a purpose other than being sleeves. Sleeves are great for coughing and sneezing. If you’re coughing/sneezing into your sleeve, you’re limiting the spread of germs into the air, protecting those around you.

Q: I’ve heard that you the flu shot can give you the flu. Is that true?

A: Definitely not! This is one of the most pervasive and frustrating medical myths out there. The flu shot contains only dead virus so there is no way it can infect you.

It is possible that the shot can induce an immune response that gives you flu-like symptoms such as muscle aches or a low grade fever, but nothing compared to getting the actual flu. If you do get the flu after a flu shot, it is likely that you were exposed to the flu or another illness before getting the shot, since it takes about 2 weeks after your shot for full immunity to develop. The flu vaccine doesn’t guarantee 100% protection; it is always possible to catch a strain of the flu not included in the vaccine.

Certain people who are at especially high risk of complications from the flu definitely need to get vaccinated every year, but the flu shot is available to anyone who wants to avoid getting the flu.

You can find information on getting the flu vaccine at OSU Student Health Services here.

Q: I stepped on a nail and am wondering if I need a tetanus shot. My last shot was 5 years ago.

A: You should probably get a tetanus shot in this case. Tetanus vaccines are given to children in the USA with a series of 5 childhood shots called the DTaP. The vaccine covers diphtheria, tetanus, and pertussis. A booster that contains vaccines to all three diseases is given between the ages of 11 and 18. After that, it is recommended that adults get the booster vaccine every 10 years, and sooner (every 5 years) if there is an injury.

What kinds of injuries are concerning?

Puncture wounds from objects like nails and bites are most susceptible to infection with tetanus. However, you can also get tetanus from any exposure to soil, including minor cuts, scrapes, and burns, and sometimes with no injury at all.

Is tetanus a bad diease?

Thanks to the vaccine, Tetanus (or “lockjaw” as it used to be known) is pretty rare in the United States, which is a good thing because it is seriously bad news. Once the tetanus bacteria get into your tissues, it starts creating toxins that interfere with nerves. This leads to muscle spasms, contractions, and ultimately, respiratory failure. We emphasize the importance of the vaccine because Tetanus is deadly and there is no cure for it.

How do I care for my wound?

It is important to take care of a skin wound to prevent infection. The steps are:

Clean the wound thoroughly with soap and water.

Use an antibiotic cream and keep the wound covered with a bandage until it scabs over.

Remember to change the dressing daily or it becomes wet or dirty.

Seek care if the wound is getting more red or painful, or if you have other concerns.

Student Health Services offers services for most non-life-threatening injuries and wounds, and the full range of adult immunizations, including the Tetanus/Diphtheria and Tetanus/Diphtheria/Acellular Pertussis boosters used most commonly in this situation. Check out our price list, in case you are concerned about the cost.

FINAL SUMMARY – if you get hurt, consider getting a tetanus shot if it has been more than 5 years since your last booster, and keep your tetanus protection up-to-date every ten years.

It’s important to note that health insurance companies vary as to what preventive medicine services they will pay for. Most base their coverage on the recommendations of several expert groups who have studied the relative value of various screening tests, immunizations, and health counseling. These groups include the CDC (Centers for Disease Control and Prevention), the USPSTF (U.S. Preventive Services Task Force), the American Cancer Society, the ACOG (American College of Obstetrics and Gynecology), the ACIP (Advisory Committee on Immunization Practices – part of the CDC) and others.

Fortunately, students between the ages of 18-45 who are in good health don’t require many preventive measures. Those that are generally recommended (and covered by insurance) are:

Annual flu (influenza) shots

A tetanus booster every 10 years (the shot actually prevents diphtheria and pertussis as well)

The HPV vaccine (Gardasil)- a series of three shots that prevent Human Papilloma Virus infection

Counseling about quitting tobacco use

Counseling about healthy alcohol intake

Counseling about physical activity

Counseling about weight

Screening for the STD’s chlamydia, gonorrhea, HIV, and syphilis

Other screening tests may be recommended (and covered) in certain situations. These include:

1. Cholesterol screening IF:

you are over age 35 (men) or over age 45 (women) OR

you are obese OR

you have a biologic brother, sister, mother, or father who has a history of Sudden Cardiac Death or cardiovascular disease (like a heart attack or heart surgery)

2. Updates on other immunizations if you have not received all the recommended shots as a child

3. For women, an annual pelvic exam, which usually includes a PAP smear and screening for STD’s

What about an actual physical examination? Believe it or not, doing a head-to-toe complete physical isn’t recommended by most of the groups above because it’s never been shown to be an effective way to screen for hidden health problems. SOME insurance companies do cover these physical exams, but the specifics of what is included may vary based on your age. For example, hearing and vision screening is often included for children and older adults, but not for young adults. When in doubt, check with your insurance company.

If you have any questions about your health or what exams, tests and immunizations you need, you should make an appointment to see us at the Student Health Center – we’re always glad to help.

And check back next week, when we finish our series on physicals by discussing the different kinds of physical exams you may come to see us for.

Q: I am going to (FILL IN YOUR DESTINATION HERE) and I don’t really think I need any shots to go there. Should I still make a travel appointment at Wilce Student Health?

A: We see OSU students traveling to nearly every destination on the globe, and the risks do vary from country to country, no doubt. However, there is more to a travel appointment than getting an exotic vaccine. Our travel medicine providers will:

· Provide current health and security information about your destination(s)

· Provide information on staying healthy while traveling, such as food and water safety, sun and insect protection, and more

· Explain and recommend travel vaccines for diseases like typhoid and yellow fever

So, even if you are traveling to a destination with limited risk, you still might want to consider coming in for some advice and recommendations.

Wilce Student Health is an Ohio Department of Health-approved vaccine site, and routinely stocks the most commonly used travel shots at reasonable prices. We also issue official World Health Organization vaccine certificates to all travel patients.

Student Health Services sees a lot of students with plans to travel internationally, either as part of one of the many OSU Study Abroad opportunities, other travel associated with academic programs, or recreational travel. Before you grab that passport and head for the airport, here are some healthy pointers:

Plan ahead – Most students plan for months or even years to get ready for international travel. Don’t forget to include health matters in those plans. Some vaccines are given in series over months, so start those early.

Talk to your health care provider about your trip – This is especially important for those students with chronic illnesses or prescriptions that they plan to continue while traveling.

Do your health insurance homework – Are you covered in Caracas? What is your deductible in Denmark? Is there a co-pay for Tetracycline in Timbuktu? Find out how your travel plans will impact your coverage.

Visit a travel expert – Our Student Health Services travel providers are ready to address your needs comprehensively, and offer an extensive selection of travel vaccines and medications. If you plan to visit someone else, make sure they are up to date on the changing health situations around the globe. (BTW, SHS is an Ohio Department of Health-certified Yellow Fever Vaccine clinic)

Be Patient! – Travel visits usually take a bit longer than a typical visit to the doctor, as each visit includes a thorough review of your health history, a discussion of your destination country’s or countries’ current health and safety conditions, and orders for all necessary medications and shots. Many students also start their vaccines at that same visit, so we would expect that you would be with us 40-60 minutes at a minimum. (All vaccines are recorded on an official International Vaccine Certificate for your convenience.)

Keep in mind, disease exposures can occur on a 3 month excursion across a continent or during a 5 day trip to a beach resort. So, come see us before you order your Spring Break airline tickets. Reduce the risk of having your trip to Cabo result in spending the first weeks of Spring Quarter sick from a preventable illness.

A: If you have the Comprehensive Student Health Insurance Plan, many immunizations are covered with no cost sharing under the Preventive Services benefit. That means you have no out of pocket expense for these immunizations. The following immunizations recommended by the Advisory Committee on Immunization Practices are covered at 100% under the Comprehensive Student Health Insurance Plan:

Hepatitis A

Hepatitis B

Hepatitis A&B

Human Papilloma Virus (HPV) for students under 27 years of age only

Influenza

Measles-Mumps-Rubella (MMR)

Meningococcal

Tetanus-Diphtheria toxoids (Td)

Tetanus-Diphtheria-Acellular Pertussis (TdaP)

Varicella (Chickenpox)

The following immunizations are covered at 50% under the Comprehensive Student Health Insurance Plan. You will be responsible for half of the cost of the immunization and administration fee:

Preventive Medicine services including immunizations are specifically excluded under the WilceCare Supplement. For more details on the WilceCare Supplement or the Comprehensive Student Health Insurance Plan, see the Student Health Insurance website.

Immunizations are considered preventive medicine services by most insurance plans. Due to recent changes in health care laws, these services may be covered when given at the Wilce Student Health Center. To find out how or if your plan will cover immunizations at Wilce (or any other facility) you will need to contact your insurance company.

These are pretty rare conditions, but being sick this time of year sure isn’t and we get asked all the time whether or not someone can get a flu shot if they’re sick. Or even worse – people just assume they can’t and we never see them! So let’s set the record straight.

If you’re sick with a cold or other mild illness (respiratory or otherwise) and you don’t have a fever, you can absolutely get your flu vaccine. If you have a fever (temp over 99.5ish), the general consensus has always been that you should hold off on getting the flu vaccine until it breaks. Why? Two reasons:

If you spike a fever right after getting the vaccine, we won’t know if you’re having a bad reaction to the vaccine (see above) or if it’s just your illness. We don’t want to confuse the matter and cause you to not get the vaccine in the future.

The vaccine might not be as effective. If your immune system is all fired up fighting an infection, your white blood cells might get confused and attack the vaccine along with whatever ails you, leading to a weaker response to the vaccine.

As you can see, neither of these issues is a safety concern – getting a flu shot while you have a fever isn’t going to hurt you. Because of this, and because influenza can be deadly even in healthy teenagers, many health care providers are starting to think it might be better to give the flu vaccine to someone with a fever and risk them having a slightly weaker response than to send them away and risk them not coming back for the vaccine at all.

When in doubt, just ask us. You can come into our pharmacy to get your flu shot between 8:30am – 4:00pm, Monday through Friday – no appointment necessary! Just go to the first floor registration desk at the Wilce Student Health Center. We’ll collect your payment; you’ll turn around and walk about 12 steps to the pharmacy where one of our highly skilled and dedicated pharmacists will administer the immunization. We’ll ask you to stick around for 10 minutes to ensure you do not have a bad reaction.

So come in and see us for your flu vaccine! To save yourself time, you can even download the 3 forms you’ll need to fill out here and bring them in with you. See how easy it is?

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